1, 2호 보호 처분 청소년의 정신의학적 특성 및 6개월 보호처분 후 추적조사

정운선(Un-Sun Chung),서상수(Sang Soo Seo),이승재(Seung Jae Lee),정성훈(Sung Hoon Jeong) 대한소아청소년정신의학회 2010 소아청소년정신의학 Vol.21 No.2

Objectives:This study investigated the differences between the psychiatric characteristics of minor juvenile offenders and normal adolescents as well as differences in psychiatric symptoms after a six month protective disposition. Further, the current study aimed at determining psychiatric screening methods for evaluating delinquent adolescents. Methods:The Latent Delinquency Questionnaire (LDQ), the Revised Children’s Manifest Anxiety Scale (RCMAS), the Children’s Depression Inventory (CDI), the Reynolds Suicidal Ideation Questionnaire (SIQ), the Piers-Harris Children’s Self Concept Inventory (SCI), and the Korean Youth Self Report (K-YSR) were administered to 134 normal adolescents (114 males) and 109 minor offenders (97 males) aged 12 to 16 years. After six months, 46 offenders (all males) completed the RCMAS, CDI, SIQ, and SCI again. Results:Adolescents with minor offenses had more delinquent, aggressive behavior and externalizing behavior problems, but were significantly less depressive, anxious, or suicidal than normal controls. Further, recidivists had more anxiety, depression, and delinquent behavior than non-recidivists. Minor offenders reported that their anxiety and depressive mood decreased after six months of protective disposition. Conclusion:Adolescents with minor offenses had more delinquent, aggressive behavior and externalizing behavior problems suggesting that psychiatric screening tools for minor offenders should measure disruptive behavior disorder.

TAS-20의 한국판 3종간의 신뢰도 및 타당도 비교

정운선,임효덕,이양현,김상헌,Chung, Un-Sun,Rim, Hyo-Deog,Lee, Yang-Hyun,Kim, Sang-Heon 한국정신신체의학회 2003 정신신체의학 Vol.11 No.1

연구목적: 1985년 Taylor 등이 발표한 TAS는 감정표현불능증을 측정하는 도구로서 1992년 TAS-20으로 개정되어 여러 나라에서 신뢰도와 타당도가 검증되었다. 본 연구는 혼재되어 쓰이고 있는 세 가지 TAS 한국판 감정표현불능증 척도를 비교하여 가장 신뢰도와 타당도가 높은 척도를 통일하여 사용하고자 시도되었다. 첫 번째 척도는 1996년 이양현 등이 개발한 것{이후 TAS-20K(1996)}이다. 두 번째 척도는 위 연구에서 "어떤 문제를 묘사하기보다는 분석하는 편이다"라고 직역한 5번 항목의 결과가 예측치와 상반되어 '분석하다'라는 단어에 대한 우리나라와 서양의 문화적 견해 차이를 고려하여 5번 문항을 수정 제안한 것{이후 TAS-20K(2003)}으로서, 타당도와 신뢰도의 호전을 검증하지 않은 것이다. 세 번째 척도는 1997년 신현균과 원호택이 TAS-20을 번역한 것(이후 S-TAS)으로 20항목의 원래 항목 수를 23개로 수정 번역한 특성을 지니고 있다. 방 법: 의학과 학생 408명을 대상으로 세 가지 척도의 서로 다른 항목, 즉 TAS-20K(1996)의 20항목, TAS-20K(2003)의 수정 제안된 1항목, S-TAS의 23항목을 무작위로 배열하여 구성된 하나의 척도를 사용하여 검사를 시행하였다. 세 가지 척도의 신뢰도를 비교하기 위해 내적 일치도(Cronbach $\alpha$ coefficients)를 구하였고 타당도를 비교하기 위해 확증적 요인 분석(confirmatory factor analysis)을 실시하였다. 결 과: TAS-20K(2003)은 TAS-20K(1996)보다 내적 일치도가 호전되었다. TAS-20K(2003)과 S-TAS는 모두 원척도의 세 요인 구조를 재현하였고, 우수한 내적 일치도와 받아들일 만한 타당도를 보여 주었다. 그러나 S-TAS는 19번 항목이 요인 2와 상관성이 낮게 나타났고, 이전 연구에서와 같이 2번 항목과 요인 1간의 상관성이 재현되지 않아 본래 요인 2에 속한 19번 항목을 요인 1에도 포함시키는 것이 타당하지 않았다. 결 론: TAS-20K(2003)과 S-TAS는 모두 원본 TAS-20의 번역판으로서 우수한 타당도와 받아들일만한 신뢰도를 보였다. 그러나 TAS-20K(2003)은 원본과 동일한 항목 수와 구조, 동일한 점수 체계를 유지하고 있으며 TAS-20은 이미 15개 이상의 언어로 번역되어 있는 도구이나, S-TAS는 항목 수 및 점수 체계, 요인 구조를 원본 TAS-20과 다르게 변형시켜 국제적인 비교 연구를 위해서는 제한점이 있다고 하겠다. 따라서 향후 감정표현불능증의 국내 연구에서 TAS-20K(2003), 즉 TAS-20K를 사용하는 것이 더 적절할 것으로 제안한다. Objectives: The purpose of this study was to compare reliability and validity of three Korean versions of the 20-item Toronto Alexithymia scale and to confirm the most reliable and validated Korean translation of the 20-item Toronto Alexithymia Scale for both clinical and research purpose in Korea. The first one was a Korean version of the 20-Item Toronto Alexithymia Scale developed by Lee YH et al in 1996 which was designated as TAS-20K(1996) in this study. This scale had a problem with one item due to the cultural difference regarding the word 'analyzing' between western culture and Korean culture. The second one was the revised version of TAS-20K(1996) on that point by Lee YH et al in 1996 without validation which was designated as TAS-20K(2003) in this study. The third one was a 23-item Korean version developed by Sin HG and Won HT in 1997, which was somewhat different from the 20-item Toronto Alexithymia Scale(TAS-20) in the number of total item, the content of some items and the scoring method. This scale was designated as S-TAS here. Methods: 408 medical students were tested with one scale composed of all the different items randomly arranged from the three versions. We evaluated goodness-of-fit and Cronbach $\alpha$ coefficients of three scales for reliability. We used confirmatory factor analysis to compare validity. Results: TAS-20K(2003) showed that it had better internal consistency than TAS-20K(1996), which implied that the cultural difference should be considered in the Korean translation. Both TAS-20K(2003) and S-TAS replicated three-factor structures and had adequacy of fit, good internal consistency and acceptable validity. However, S-TAS had one item with poor item-factor correlation and didn't show high correlation between item 2 and factor 1 as before in 1997. Conclusion: Although S-TAS had added 3 items and changed the content of two items, it didn't show better reliability and validity than TAS-20K(2003). Therefore it is proposed to use TAS-20K (2003) as the Korean version of the 20-item Toronto Alexithymia Scale(TAS-20K) for international communication of results of Alexithymia research. It has good internal consistency and validity and maintains original items, the same construct and scoring method as the 20-item Toronto Alexithymia Scale.

소아.청소년에서 아토피 피부염과 주의력결핍과잉행동장애와의 관계

한덕현,김성현,정운선,조정혜,박준성,안지영,김재원,Han, Doug-Hyun,Kim, Seong-Hyun,Chung, Un-Sun,Cho, Jeong-Hye,Park, June-Sung,Ahn, Jee-Young,Kim, Jae-Won 한국정신신체의학회 2006 정신신체의학 Vol.14 No.2

연구목적 : 본 연구에서는 소아청소년들의 아토피 피부염과 주의력결핍과잉행동장애 (Attention Deficit Hyperactivity Disorder : ADHD)의 관계에 대하여 알아보고, 더 나아가서 아토피 피부염 환자를 MAST 양성 및 음성의 아토피 피부염 환자로 분류하여 ADHD와의 관계에 대하여 알아보고자 하였다. 방법: 본 연구에는 아토피 피부염 아동 69명과 정상 대조군 42명이 참여하였다. 피부과 전문의가 아토피 피부염에 대하여 평가하고 중증도를 측정하였으며, 아토피 피부염 아동을 대상으로 MAST 검사를 시행하였다. 부모용 ADHD 평가척도로 환자군 및 대조군의 ADHD 증상을 평가하였다. 결과: 아토피 피부염 환자군에서 정상 대조군에 비해 ADHD 평가척도의 총점, 주의력결핍 및 과잉행동/충동성 증상의 점수가 유의하게 높은 것으로 나타났다(t=3.35, p<0.01 ; t=6.41, p<0.01 ; t=3.93, p<0.01). ADHD로 정의된 아토피 피부염 환자군 중 과잉행동/충동성 군에서 주의력결핍 군에 비해 중등도의 아토피 피부염 환자의 수가 더 많은 것으로 나타났다. $({\chi}^2=4.74,\;p=0.04)$. MAST 검사에서 양성 반응을 보인 아토피 피부염 환자들에서 MAST 음성 반응을 보인 환자들에 비해 ADHD의 증상이 더 높은 비율로 나타났다. $({\chi}^2=9.82,\;p<0.01)$. Objective : The aim of this study was to examine the relationship between IgE-mediated atopic dermatitis and attention deficit hyperactivity disorder(ADHD) in Korean children. Method : This case-control study included 69 patients with atopic dermatitis and 42 normal students. Diagnoses of atopic dermatitis and assessments of its severity were made by the dermatologist. The MAST tests were administered to atopic dermatitis patients. The parents of all of the subjects completed the parent versions of the ADHD Rating Scale-IV(ARS). Results: Compared to the normal control group, the atopic dermatitis group scored significantly higher in the total, inattention, and hyperactivity/impulsivity profiles of the ARS(t=3.35, p<0.01 : t=6.41, p<0.01 ; t=3.93, p<0.01, respectively), The atopic dermatitis patients with ADHD hyperactivity/impulsivity subtype showed more severe symptoms of atopic dermatitis than those with ADHD inattentive subtype. The MAST-positive atopic dermatitis patients showed significantly increased incidence of ADHD symptoms than the MAST-negative counterparts. Conclusion : The results of this study suggest the possibility of an association between IgE-mediated atopic responsiveness and ADHD symptomatology.

초등학교 저학년 대상 ADHD 단독군, 동반 질환을 가진 ADHD군에서의 10회기 사회기술 훈련의 효과 비교

이소희(So Hee Lee),정운선(Un Sun Chung),황선영(Sun Yung Hwang),정재훈(Jae Hoon Jeong),김은지(Eun Ji Kim),우정민(Jeong Min Woo),조현영(Hyun Young Jo) 대한소아청소년정신의학회 2015 소아청소년정신의학 Vol.26 No.4

Objectives:Children with attention-deficit hyperactivity disorder (ADHD) have problems in social interactions. We compared the effect of 10-session social skill training (SST) among two groups, children with pure ADHD, and those with ADHD with comorbidity. Methods:Consecutive 10-session SST was conducted for 34 children from 2006 to 2012. There were 22 children with pure ADHD (male 20, female 2), and 12 children suffering from ADHD with comorbidity (male 11, female 1). All children took medication as prescribed by their doctors before the start of SST. The Child Behavior Checklist (CBCL), the Korean Personality Inventory for Children (K-PIC), the Conner’s Rating Scale, the ADHD Rating Scale, and the Home Situation Questionnaire were completed by mothers before and after the SST. All children completed the Child Depression Inventory, the Stat-Trait Anxiety Inventory for Children, the Self-Concept Scale and the ADHD Diagnostic System before and after the SST. Results:Only children with pure ADHD showed improvement in anxiety and self-concept in scales rated by children. In the CBCL rated by parents, the pure ADHD group and the ADHD with comorbidity showed improvement in both externalizing and internalizing subscales. In the K-PIC rated by parents, the pure ADHD group showed improvement in most outcomes and ADHD with comorbidity showed positive change in verbal development. Conclusion:These results suggest that SST has significant positive effects on both the pure ADHD and ADHD with comorbidity group. Further research is needed in order to target diverse comorbidity groups with ADHD to improve the effectiveness of the SST.

설사증 라환견(羅患犬)으로 부터 분리한 Canine Parvovirus의 성상에 관한 연구

최해연 ( Hae Yeon Choi ),정운선 ( Un Sun Chung ),전무형 ( Moo Hyung Jun ),박성국 ( Seong Kuk Park ),민원기 ( Won Gi Min ) 한국가축위생학회 1990 韓國家畜衛生學會誌 Vol.13 No.2

From 1988 to 1989, 8 strains of canine parvovirus-2 (CPV-2) were isolated from the fecal specimens from the dogs that were clinically diagnosed as canine parvoviral enteritis in the veterinary hospitals located in the regions of Taejon and Chungbuk province. Studies on biological and physicochemical properties for the isolates were carried out. The results obtained by experiments are summarized as follows. 1. Among 62 fecal samples collected from the dogs with enteric diseases, 24 (38.7%) showed the haemagglutinating activity against porcine erythrocyte, ranging from 16 to 16,384 of HA titers. 2. When 8 fecal specimens with high HA titer over 1,000 were inocultated into CRFX cells, intranuclear inclusion bodies were obseverd in all of eight specimens, of which three specimens showed cytoplasmic inolusions concurrently with the intranuclear inclusion bodies. 3. In study on species-specificity of haemagglutinating activity of the isolates, TJ-89-1 and TJ-89-2, it was found that the isolates revealed the highest haemagglutinating activity with porcine erythrocytes, showing the relatively lower haemagglutination titers with the erythrocytes from cat and rabbit. None of erythrocytes from other animals reacted with the isolates. 4. By the cross-haemagglutination inhibition test of the isolates with reference viruses and sera, the isolates were evidently identified as the strains of canine parvovirus-2. 5. In physicochemical property test, it was evident that the isolates were stable in lipid solvent, pH and heat treatment at 56℃ for 30 mm. and contain DNA genome. 6. When seven puppies were inoculated intraorally with the isolate at HA titer of 8, 192, all of the puppies showed the symptoms of anorexia, vomiting, diarrhea and died at the 5th to 10th days post inoculation(pi). The fecal samples from all of the puppies revealed significantly high HA titers afterward the 5th days pi. Body temperature and the number of total leucocytes were slightly increased at the early stage of infection, but extremely decreased at the stage of collapse. HI titers of the sera started to increase at the 2nd to 3rd days pi reaching 512 to 1,024 at the 4th to 5th day pi.

아동의 문제 행동에 따른 어머니-아동 상호작용 행동 및 가족지각에 대한 연구

진미경 ( Mi Kyoung Jin ),정운선 ( Un Sun Chung ),정성훈 ( Sung Hoon Jeong ) 한국놀이치료학회 2011 한국놀이치료학회지(놀이치료연구) Vol.14 No.1

본 연구는 어머니-아동 상호작용 행동과 아동의 가족에 대한 인식이 아동의 문제행동과 어떠한 관련성이 있는지 살펴보는 것이 목적이다. K대학병원 소아정신과를 내원한 6-9세 연령의 48명의 아동과 어머니들이 연구에 참여하였다. 정서적 가용성 척도(Emotional Availability Scale)를 통해 어머니-아동 상호작용 행동이 평가되었고, Fury의 가족화 척도를 통해 아동의 가족에 대한 인식을 평가하였으며, 아동인성검사(K-PIC)를 통해 아동의 문제행동을 평가하였다. 그 결과 아동의 자아탄력, 우울, 비행문제 상하 집단에 따라 어머니-아동 상호작용에 있어 차이가 있었다. 또한 아동의 불안, 우울, 비행, 과잉행동, 가족관계 문제, 사회관계 문제 상하 집단에 따라 아동의 가족에 대한 인식에 있어 차이가 나타났다. The purpose of this study was to examine whether there are differences (1) in mother-child interactions in accordance with child behavior problems, and (2) in child`s perception about family in accordance with child behavior problems. In this study, the participants were forty eight children whose age spans between 6 and 9 and their mothers who visited K university hospital. Mother-child interactions were observed through the emotional availability scale (EAS) while family drawings were evaluated through Fury`s family drawing scale. Mothers completed Korean Personality Inventory for children (K-PIC) to check children`s behavioral problems. The results showed that mother-child interactions differed from the high and low scores they attained in each scale of child behavior problem: ego resilience, depression, delinquency respectively. Also, children`s perceptions about family were different from the high and low scores they attained in each scale of child behavior problem, anxiety, depression, delinquency, hyperactivity, family, and social problem, respectively.

친구의 자살이 청소년의 정신 건강에 미치는 영향

강나리(Na Ri Kang),정운선(Un Sun Chung),곽영숙(Young Sook Kwack) 대한소아청소년정신의학회 2015 소아청소년정신의학 Vol.26 No.4

Objectives:This study examined the impact of peer’s suicide on mental health of middle-school students. The aim of this study was to describe the course of posttraumatic stress and grief reaction, suicide ideation, and depression score among adolescents after exposure to peer’s suicide and to examine the relationship between posttraumatic stress and other mental health scores in these subjects. Methods:Thirty seven middle school students who were exposed to the suicidal death of a peer completed self-report measures to assess levels of depression, grief reaction, post-traumatic stress, and suicide ideation at 1 month and 8 months after the peer’s suicide. Results:There was no significant change in mental health scores between 1 month and 8 months. Level of posttraumatic stress after 8 months was related to acute grief response. Subjects who experienced a clinically significant level of suicidal ideation and posttraumatic stress showed more mental health problems. Conclusion:The results suggested that peer’s suicide strongly impacted mental health issues of adolescents at a critical time of adolescent development. Clinicians should perform a thorough evaluation of mental health problems for youth who experienced peer’s suicide and help them in management of their grief reaction.

자폐장애 아동의 약물효과 평정을 위한 이상행동 체크리스트 예비연구

문덕수(Duk-Soo Moon),정운선(Un-Sun Chung),정성훈(Sung Hoon Jung),조아랑(Ah Rang Cho),반건호(Geon Ho Bahn) 대한소아청소년정신의학회 2013 소아청소년정신의학 Vol.24 No.3

Objectives:We assessed the availability of Aberrant Behavior Checklist (ABC) for the evaluation of the pharmacological effect in autistic disorder. Methods:A retrospective review of the medical records of 27 children with autistic disorder, who visited the department of child and adolescent psychiatry of Kyungpook National University Hospital, from October 2011 to February 2013, was conducted. After treatment with risperidone, changes in the severity and improvement of symptoms were measured using ABC at the baseline, 2nd visit and 3rd visit, respectively. Results:The mean daily dose of risperidone increased from 0.66±0.27mg (baseline, initial dose) to 1.02±0.50mg, 2nd visit, and 1.19±0.50mg, 3rd visit. According to ABC, irritability, lethargy, hyperactivity, and inappropriate speech subscale scores decreased significantly from the baseline to 2nd visit. Irritability and Hyperactivity subscale scores decreased significantly from the 2nd to 3rd visit. All subscales and total scores of ABC decreased significantly from the baseline to 3rd visit. Conclusion:The results of this study suggest that ABC can be used as an efficient tool to measure the symptoms of autistic disorder and to evaluate the medication effect on continuous treatment.

한국인 주의력결핍-과잉행동장애 아동의 세로토닌 수송체 유전자 다형성

조수철,손정우,김붕년,김재원,유희정,황준원,조대연,정운선,박태원,Cho, Soo-Churl,Son, Jung-Woo,Kim, Boong-Nyun,Kim, Jae-Won,Yoo, Hee-Jeong,Hwang, Jun-Won,Cho, Dae-Yeon,Chung, Un-Sun,Park, Tae-Won 대한생물정신의학회 2009 생물정신의학 Vol.16 No.1

Objectives : The aim of this study was to investigate the association between Korean ADHD patients and the l/s polymorphism of serotonin transporter(5-HTTLPR). Methods : The study sample consisted of 189 Korean ADHD children diagnosed by Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean Version(K-SADS-PL), both parents of ADHD children, and 150 normal children. DNA were extracted from the blood of all samples, and genotyping was done. Based on the allele and genotype information, not only the case-control analysis between ADHD and normal children but also the family-based association test among ADHD children and their parents. Transmission disequilibrium test(TDT) were performed for family-based associated test(number of trio=113). The results of the clinical rating and neuropsychological tests were compared according to the l/s genotype of ADHD children. Results : In case-control analysis, there were no statistically significant difference of l/s gene polymorphism between ADHD and normal children in various kinds of analysis condition. In family-based association study, TDT failed to detect linkage disequilibrium between l/s gene polymorphism and ADHD in whole ADHD families. However, in the families of ADHD inattentive type only(number of trio=23), I allele was transmitted more preferentially in the proband with ADHD even if the number of families was small(${\chi}^2$=4.57, p=.032). In the analysis of the results from the clinical scales and neuropsychological tests in ADHD children, the score of the Novelty- Seeking of ADHD children with l/l genotype was significantly lower than with the other genotypes(F=3.15, p=.047), and that of Self Transcendence was significantly higher(F=4.25, p=.017). Conclusion : The results of this study suggest there were no significant genetic association between the 5- HTTLPR gene polymorphism and Korean ADHD.

한국판 아동용 외상 후 증상 보고와 부모용 외상 후 증상 보고에 대한 신뢰도 및 타당도 연구

이광민(Kwang-Min Lee),정성훈(Sung Hoon Jeong),이원기(Won Kee Lee),정운선(Un-Sun Chung) 대한소아청소년정신의학회 2011 소아청소년정신의학 Vol.22 No.3

Objectives:The Child Report of Post-traumatic Symptoms (CROPS) and the Parent Report of Post-traumatic Symptoms (PROPS) are screening measures for post-traumatic symptoms in children. The present study aimed to investigate the reliability and validity of the Korean versions of the CROPS and the PROPS. Methods:The Korean versions of the CROPS and the PROPS were administered to a sample of 304 children aged 6 to 15 years old. The internal reliability, test-retest reliability, factorial validity, predictive validity and concurrent validity were evaluated. Results:The reliability of the CROPS and the PROPS was shown to have excellent internal consistency and test-retest correlation. The single factor structure of the PROPS was good and that of the CROPS was borderline acceptable according to confirmatory factor analysis. Other validity measures such as the predictive validity and concurrent validity were also shown to be satisfactory. Conclusion:This study demonstrated that the Korean versions of the CROPS and the PROPS were reliable measures with satisfactory psychometric qualities. Because it takes less than 5 minutes to fill out the CROPS and the PROPS, respectively they can be quick and easy screening scales for assessing post-traumatic symptoms in Korean children.